Have you developed Agoraphobia?
For many people these days, the lockdown has meant staying indoors and self-isolating. Agoraphobia is an anxiety disorder that can leave people feeling housebound for years. You may have battled with agoraphobia for a long time. Lockdown conditions may have restricted you from leaving the house. This means that your anxiety could have gotten worse since the COVID-19 pandemic.
What is Agoraphobia? If you are afraid of meeting people then the prospect of going out again might feel scary. ‘Small talk’ with neighbours might fill you with dread. If you are an introvert, lockdown may provide the perfect excuse or legitimate alibi to stay at home. Does the extension of lockdown feel reassuring? Existing anxiety conditions like GAD, OCD or panic disorder might increase your struggle. At times it might feel like a difficult condition to manage. Agoraphobia isn’t a fun disorder but you can work through the anxiety with trauma-informed therapy which helps to prevent your condition from growing into full-blown agoraphobia.
We all have personal ‘lockdown’ days when even answering the phone feels too much. Some people have to live with their phone set on ‘Do Not Disturb’. If you are one of those people then you may prefer to communicate via text messaging and email instead. For some others, the ringing phone is a force-field that can trigger a freeze response. This might feel more intense especially if it’s from an unidentified caller. Extreme anxiety makes important calls to the doctor and official tasks a struggle.
“I can breathe again when the phone stops ringing!”
Agoraphobia is a similar mental health condition to Social Anxiety. Some people find it uncomfortable to be around other people. Any kind of attention can trigger anxiety. People who suffer from agoraphobia are hypervigilant, avoidant of crowds. It is natural to protect against pre-existing fears. Going outdoors can increase flashbacks and panic attacks occurring in public.
Causes of agoraphobia
Childhood trauma makes people susceptible to Complex PTSD, General Anxiety Disorder and Panic Attacks. Trauma results from repetitive and long-term adversity in childhood and adulthood. Child sexual abuse and bullying at school can also trigger intense anxiety. Emotional calluses, from survival years, can feel picked at when trauma gets triggered. The world can feel like a confusing, unsafe and overwhelming place. Leaving the house for work, and visiting the doctors can all seem daunting and can take everything out of you.
Domestic violence & sexual abuse attacks a person’s vulnerability and cause agoraphobia.
Insecurity in women, arising from defencelessness can develop into a fear of men. Fear of injustice can be a distressing trigger for victims of sexual assault. Some feel helpless over legal outcomes. Others may think it illogical, or that not enough is being done to protect victims of heinous crimes. Some fear that their sexual predators might ‘get away with it’.
Victims of sexual abuse find it difficult to ‘rationalise’ feelings. It might feel very real and plausible that a man will hurt you again. Any underlying mental health conditions can exacerbate feelings of anxiety. It might feel harder because your experience confirms your truth of lived experience.
Complex mental health problems
Persistent and prolonged depression is one of the most common mental health conditions. Long term anxiety and complex PTSD can be debilitating and mentally exhausting. Left ignored for a long time this can lead to agoraphobia. People with Bipolar Disorder experience agoraphobia between cycles of mania and depression.
Any underlying PTSD can be the cause of persistent anxiety including agoraphobia. Complex-PTSD is a mental health condition related to abuse and neglect in childhood. It is understandable that you may want to hide your symptoms from your family. Concealing shame and embarrassment is a natural reaction to protect your modesty. Fibbing is a form of denial, a psychological defense, of deeper rooted toxic shame. ‘Passing off’ symptoms might feel safe, and a temporary way for covering up symptoms. It is easier to make light of a situation, making it also feel acceptable.
You can develop sudden and severe agoraphobia after a traumatic event in adulthood. A female client recently described severe agoraphobia after abuse from a stalker incident.
Agoraphobia is also triggered by serious illness. Your immune system may be further compromised after invasive treatments like chemotherapy. Anxiety accompanying an illness like epilepsy can escalate and trigger a full-blown seizure. The COVID-19 situation hasn’t helped, and your anxiety might feel worse.
Disabilities “I developed agoraphobia after disability. I left my job 2 years ago. I went from being active & social to rarely leaving my house. I am devastated. I was very embarrassed. I went from a good job to living on welfare. My family turned against me, accusing me of being lazy. I have a diagnosis of fibromyalgia & chronic fatigue syndrome. I was so sick. Turns out it was severe complex PTSD. I couldn’t go grocery shopping if my life depended on it. Luckily I had a friend who would do it for me. It’s come back again full swing since COVID”.
The COVID-19 pandemic has caused a lot of stress to most people. Widespread panic about social distancing in stores is not helpful. The growing desperation doesn’t help your condition. Global influences reported by social media can exacerbate anxiety and symptoms of agoraphobia. The news is full of traumatic stories. Continual distressing news about violence, shootings, and acts of terrorism doesn’t help either. Environmental events remain out of your control. This can trigger past memories that serve as reminders of past trauma. You might consider something as normal as going outside to be an ‘event’. The fear of getting infected has made many people nervous about going out. Lockdown has made an existing problem worse. You may experience greater hyper-vigilance. You may be over anxious about taking extra precautions. Over-thinking staying safe, social distancing, masks etc. makes it even harder.
“Going out can feel completely draining, like the life has been sucked out of you.”
The COVID-19 lockdown has caused a return of agoraphobic symptoms. , reversing any progress of getting themselves outdoors before the pandemic. Some people have lost all sense of feeling safe. You may have seen altercations with angry others. There are judgements about ‘anti-maskers’. You may have a fear of infection that also makes you paranoid about infecting others. You may be extra conscientious about social distancing rules. Dealing with others’ angry gestures reminding you about social distance can also be tedious.
Symptoms and struggles with agoraphobia
We get our Social needs met through going out, meetings friends, colleagues and family. This option is not available in the usual way these days. Working from home has taken this opportunity away from a lot of people. Normal activities like doctor’s appointments and food shopping done online. A new normal replaces our familiar old ways of connecting with the outside world.
“I’ve dealt with this for sure when things get rough. I know how tough it is, but you’ve got to keep going out before it gets to the point of no return”.
Remaining connected to the outside world is essential for mental health and wellbeing.
How can you find a healthier way to deal with your underlying anxiety?
Agoraphobia is like social anxiety. Symptoms come and go ranging from manageable to severe. Some people fear anything that involves other people. Sometimes it can also be difficult to distinguish symptoms from those of Depression. There may be several days when getting yourself out of bed to eat and get to the bathroom is a drag.
“Normally, on sad, empty days, I can go to bed and reset for the most part, but the uncertainty of not knowing when the anxiety of having to face others will lift is painful. I know how irrational it is, but just being aware of it doesn’t help”.
If you feel you’re suffering all alone with this condition, please know that you’re not the only one.
Agoraphobia is a bewildering condition that can affect your interpersonal relationships.
Agoraphobia can cause feelings of stuckness. You may be familiar with the feeling of ‘going backwards’. It might be tempting to hide. Staying at home might feel more comfortable. You might feel conflicted about saying “No” to a friend’s invitation. Your relationships and friendships might bring you a mixed sense, a push-and-pull-feeling.
It is normal for some people to feel ashamed about their feelings. If you don’t feel safe or in control, you might find it hard to function outside the house. This might feel worse the longer you stay in. With the help of therapy, it is easy to reduce anxiety of past trauma. You might feel bad about your feelings, or feel that people are not approachable. If you are not good at making friends, you might even make false self-judgements. You might experience unhelpful thoughts. You might harbour unhealthy beliefs about being deceptive or a bad person. You might harbour feelings of shame for being different. that you’re freaking other people out, or that you are. You might withdraw from people. You might also prefer to shelter yourself, staying at home way more often than normal.
“There’s the rebound effect where I crave human connection, but it’s pretty hard for everyone one else when I’ve been so diligent in avoiding everyone during those ‘storms’. It’s rough because no one understands, but how can I expect them to when I myself realise how crazy it is!”
Fear of triggering anxiety might find you restricting going out for absolute essentials. There may be specific triggers that affect your anxiety to spike. Small enclosures, certain noises, lights, in-store checkouts might trigger reminders of past events. Familiar feelings associated with being stuck in traffic or crowds can increase anxiety. Your symptoms might range from minor anxiety to a full-blown cold sweat panic attack. It is common to experience adverse reactions like nausea and sweating.
Fear grips people to an extent that the only way they can go places is with a partner. Some people find it difficult to travel without sedatives or medication. Routine activities like food shopping or a doctor’s visit can feel daunting. Sometimes this can only be possible by calling a taxi.
Staying ‘inside’might protect you from feeling ‘fully outside’. You might prefer to ask for a ride to the shops or wait in the car. is the preferred option, while someone else, usually a partner or spouse goes into the shop.
Some common behaviours include
- waiting until it is dark before putting the rubbish out
- leaving it until you’ve run out of food before going shopping.
“I can’t even be around my caregiver”.
What to do about agoraphobia?
Here’s a list of a few of these.
- Therapy can help you to process the anxiety as well as teach you some coping strategies.
- Calming the high arousal levels with medication. Medication is a temporary fix. It helps to reduce anxiety by ‘bringing everything down’ to a manageable level. Medication can help to calm the system and give you the gradual lift you need. Unfortunately, medication accompanies side-effects that can leave you feeling spaced-out, drained and lethargic.
- Mindfulness is an east-meets-west approach for emotional regulation. You can learn to relax your mind and body. This can help you to connect with yourself in a deeper way. When you relax your body, it is easier to locate where you might be holding on to repressed negative energy.
- Controlled gradual exposure, starting with familiar places such as your own back garden.
- Getting organised can help by arranging errands in such a way that you don’t have to go out more often than you have to.
- Feeling safe with a pet – taking your dog with you when you leave the house.
Psychotherapy for agoraphobia
At times it might feel a hard condition to manage. It isn’t a fun disorder!
Psychotherapy provides a safe and confidential space. An integrative approach including CBT can help by exploring thoughts, feelings and behaviours.
Look for a professional psychotherapist with the right training, skills and experience. EMDR Therapy and CBT (Cognitive Behaviour Therapy) provide relief from agoraphobia. Working through anxiety in therapy can help you to go outside, and even make it enjoyable!
Contact me today.